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PL-17-2929Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Permit Parcel Number Permit NO. PL-12-17-2929 Permit Type: Plumbing - Residential Work Classification: Gas Permit Status: APPROVED Expiration: 06/16/2018 Applicant 9701 NE 13 Avenue Miami Shores, FL 1132050090540 Block: Lot: ROBERT ARDER Owner Information Address Phone Cell ROBERT ARDER 9701 NE 13 AVE Miami Shores FL 33138 305-322-0063 Contractor(s) LASSETER PLUMBING CO INC Phone Cell Phone (305)525-5075 (305)893-7180 Valuation: Total Sq Feet: $ 1,500.00 0 Type of Work: GAS Type of Piping: Additional Info: Bond Return : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $1.20 $2.25 $2.00 $0.40 $150.00 $3.00 $1.60 $160.45 Pay Date Pay Type Invoice # PL-12-17-65891 12/18/2017 Check #: 2859 12/13/2017 Check #: 2858 Amt Paid Amt Due $ 110.45 $ 50.00 $ 50.00 $ 0.00 l(-4, 0?90 ogod Available Inspections: Inspection Type: Final Press Test Review Plumbing In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibili or :11 work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELEC "ICAL, PLUMBING, CHA AL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS A constructi Authorize T: I ce ature: Owner / Applicant ation is accurate and that all work will be done in compliance with all applicable laws regulating contractor to do the work stated. Contractor / Age December 18, 2017 Date Building Department Copy December 18, 2017 1 Address: 9) 2/ ti /.37-6` /fre City: / Dili Dfee-- State: BUILDING PERMIT APPLICATION ❑ BUILDING ❑ ELECTRIC i�PLUMBING ❑ MECHANICAL Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑ ROOFING R EI VED DEC I82017 FBC20MS Master Permit No. la -In'-' 1221 Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 2>O / ,' .6 % 31-4 4t1-9t City: Miami Shores Folio/Parcel#: County: Miami Dade //- ?2 , nog 0 /o Occupancy Type: Load: ,, OWNER: Name (Fee Simple Titleholder) a�)-' 7 2444 07 Phone#: Is the Building Historically Designated: Yes 3 3/ 3F- NO (/ Construction Type: Flood Zone: BFE: Ce f 6 _ JI Zip: 33/ 32 Tenant/Lessee Name: Phone#: Email: Ale/ Ai /- Q®<< Coni CONTRACTOR: Company Name Lisc e/td2 Ltl416iiL (6) Address: 626� Ne /3 2 r4 Si City: •'7 /"Qirpt Qualifier Name: State: 060 Mi. Phone#: =10,C 8 /. j CPO Zip: 3 3/(O� Phone#: c" 31%/Uor State Certification or Registration #: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 1 IS Oc7 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration n New ❑ Repair/Replace IT Demolition Description of Work: • r rfr e. :f. ie',0 j - Y , At Specify colorof,co/or,thru,,ti e:, " �; " Submittal Fee $ 50�D Permit Fee $ / rb Scanning Fee $ 1-"�' Radon Fee $ Technology Fee $ Structural Reviews $ Training/Education Fee $ CCF $ DBPR $ 1.� � 1('� J c„*. t, i}; i, Ye.4 r� rn rrtn Y{� •L �: '. .r rA V„!nh it t ,V. 0.,y i CO/CC $ Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ J (Revised02/24/2014) Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS'TO YOUR PROPERTY. 'IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.", Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a r nsp ction fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this /01X day of . eGern,bi , 20 / r/ , by Rabe Aug- , who is personally known to me or who has produced aA identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: as Signature DeL4 CONTRACTOR The foregoing instrument',was acknowledged before me this /c ` day of eGPM�'� , 20 / / , by Toh,J GAfsef�-- , who is personally known to me or who has produced /1 IA identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: Its Commission N GG 065643 My Comm. Expires Jan 24.2021 ''bonded through National Notary Assn ************************************************************************************************************ as v APPROVED BY 1y ✓ Plans Examiner Structural Review Zoning Clerk (Revised02/24/2014)